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Diagnosing your baby's reflux

In most cases, your doctor will be able to make a diagnosis of reflux based solely on your baby's physical signs and symptoms without the need for doing any particular tests. However, if a diagnosis isn't clear, or treatments for reflux are not alleviating the symptoms, then testing for reflux may be suggested to rule out other conditions that may need different treatments.

Tests for reflux

Research has shown that in many cases, testing for reflux may not determine the cause of your baby's reflux, or indeed, that that your baby has reflux at all. However, if testing is suggested - and you are happy to proceed with the test - one of the following tests will be performed:

·A barium swallow and 'upper GI series'

This test involves feeding your baby an x-ray detectable liquid called barium and then having multiple x-rays taken, as the barium moves though his oesophagus, stomach and intestines. This test only looks at one snapshot in time, and is generally of more use if your doctor is concerned about any physical abnormalities in your baby's oesophagus, stomach or bowel, as a cause for the reflux or discomfort. Another substance that can be given to swallow is called technetium.

·24 hour monitoring of the acid levels in the oesophagus

This test is known as oesophageal pH monitoring and is done with a fine wire pH probe. The wire has a small sensor on the end and is threaded down your baby's nose, moving down to the top of the oesophagus and stomach. It aims to measure the level of acid at different times of the day, before during and after feeding and/or vomiting. A pH level of less than four (or '< 4') may indicate that acid is irritating the oesophagus. This test aims to link low pH levels with your baby's irritable or distressed behaviour associated with reflux.

·Endoscopy

This test takes small biopsies of the oesophagus. It involves passing a flexible tube with a small camera on the end, down your baby's throat, to allow your doctor to see first-hand any possible inflammation of the oesophagus, stomach and intestine. Small samples (biopsies) of the lining of the oesophagus may be taken for a pathologist to examine. This test should only be performed in a specialised centre, by someone experienced in performing this test and may be recommended if it is thought that your baby may have severe reflux. He may need to be sedated, or have a mild general anaesthetic for this procedure.

·Scintigraphy

This test involves your baby being fed a liquid or solid, that is scanned several times as it passes through the baby's digestive tract.